High-dose radiotherapy alone for patients with T4-stage laryngeal cancer

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• 作者：A. Mucha-Ma?ecka MD ; PhD (1)
  K. Sk?adowski MD ; PhD (2)
  
• 关键词：Laryngeal cancer ; Radiotherapy ; Extralaryngeal infiltrations ; Emergency tracheostomy ; Prognosis ; Larynxkarzinom ; Strahlentherapie ; Extralaryngeale Infiltration ; Notfalltracheotomie ; Prognose
• 刊名：Strahlentherapie und Onkologie
• 出版年：2013
• 出版时间：August 2013
• 年：2013
• 卷：189
• 期：8
• 页码：632-638
• 全文大小：529KB
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• 作者单位：A. Mucha-Ma?ecka MD, PhD (1)
  K. Sk?adowski MD, PhD (2)
  
  1. Department of Radiation Oncology, Center of Oncology, Maria Sklodowska-Curie Memorial Institute, Garncarska 11, 31-115, Krakow, Poland
  2. Department of Radiation Oncology, Center of Oncology, Maria Sklodowska-Curie Memorial Institute, Wybrze?e Armii Krajowej 15, 44-101, Gliwice, Poland
  

文摘

Background and purpose The purpose of this retrospective study was to report on the efficacy of radiotherapy alone in patients with T4-stage laryngeal cancer and to establish the prognostic value of (a) the size and location of the extralaryngeal tumor extensions and (b) of emergency tracheostomy. Patients and methods A group of 114?patients were treated with definitive radiotherapy between 1990 and 1996. The piriform recess was involved in 37?cases (33-), the base of the tongue and glosso-epiglottic vallecula in 34?cases (30-), and the hypopharyngeal wall in 10?cases (9-). In 16 cases (14-), emergency tracheostomy was performed before radiotherapy. The mean total dose was 68?Gy (range, 60-7.6?Gy). The mean treatment time was 49?days (range, 42-4?days). Results Actuarial 3-year local control (LC) was noted in 42- of patients, disease-free survival (DFS) in 35-, and overall survival (OS) in 40-. The best prognosis was for the lesion suspected of cartilage infiltration: 56- 3-year LC. The worst results were noted in the cases with massive infiltrations spreading from the larynx through the hypopharynx: 13- 3-year LC. Emergency tracheostomy before radiotherapy was significantly connected with the worst treatment results (p--.000): 3-year LC in patients with tracheostomy was 0- vs. 48- in patients without tracheostomy. Conclusion Conventional radiotherapy of T4 laryngeal cancer is a method of treatment with limited effectiveness. The efficacy of radiotherapy is dependent on the location and extent of extralaryngeal infiltrations. Emergency tracheostomy is a prognostic factor connected with the worst prognosis.